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When I’m teaching and explaining about neural tension, I affectionately call nerves the “divas” of the body. This is an appropriate title for a number of reasons: they are very particular about the amount of movement and space required to function properly, sometimes they don’t let you know until hours later if they are irritated, and they can take a long time to heal when injured.
Okay, so before I go too crazy with my diva analogy, let’s take a step back and talk about the nervous system as a whole. It all starts with the brain, which of course contains the control centers for movement, thought, emotions, survival, and hormone regulation. The brainstem is then connected to the spinal cord, which travels along the center of the vertebral column. The nerves that are responsible for upper body movement and sensation exit from the 7 neck (cervical) vertebrae, and those for the lower body from the lower back (lumbar vertebrae). The centers for the control of our organs and other involuntary body processes are located in the thoracic spine, or the portion of the spine that also serves as the connection for the ribs.
Therefore, the nervous system is continuous and omnipresent throughout all the tissues of the body. The peripheral nerves, or the ones that spread out into the arms and legs to control movement and sensation, must travel through muscles, fascia, and specific tunnels of the skeletal system. If these nerves don’t have the proper amount of movement, bloodflow, and space, they are unable to function and process information properly. If we think about our nerves as wires carrying information, the compromise of the aforementioned factors results in “error messages”. These error messages can be in the form of numbness, tingling, tension, burning, or pain. Additionally, these error messages can cause trigger points to be deposited in the muscle belonging to that irritated nerve. This is why there are common clusters of muscles that are painful when certain nerves are involved in the injury process.
“Neural tension” is the term used to describe this phenomenon where the peripheral nerves aren’t sliding and gliding through the tissues optimally. There are a multitude of mechanisms why this can occur, including, but not limited to: repetitive movement, prolonged inactivity or pressure (like falling asleep on your arm), muscle/fascial tension, bone spurring or narrowing of joints, or disc issues in the spine. Healthcare practitioners can perform numerous tests to determine if neural tension is contributing to one’s symptoms, as well as to help pinpoint where the nerve may be getting caught.
If the nerve is a significant contributor to the symptoms being experienced, it is important to tend to it correctly. Tension that is derived from neural entrapment does not respond well to prolonged stretching, and stretching exercises found via Dr. Google may actually make the condition worse. It is really important to get the correct type of exercises to aid in the healing process.
In situations where the nerve is involved, we will oftentimes prescribe nerve glides or “sliders”. Just as we know certain positions of the joint that will stretch specific muscles, there are certain positions and movements that will selectively tension specific nerves. Nerve glides are a specific, sequential movement pattern aimed at improving the nerve’s ability to move through the tissue of the body. These have to be prescribed carefully, as the tolerance to this type of exercise will vary greatly person to person. Occasionally it will take some experimentation to find the right type and dosage of nerve glide. This is why working with a professional in this situation is important.
Want to know more? Need help deciding how to best address your issue? Skip over Dr. Google and come see us, we can help you tame your "diva".
Keep going, you got this!
Kacy Seynders, PT, DPT